Headspace

Short answer: online therapy platforms connect you with licensed human clinicians for scheduled or on-demand therapy (and sometimes medication management); mental‑health apps are mostly self‑guided tools (or AI/chatbot/coaching services) for tracking mood, learning skills, guided meditation, or brief check‑ins. Both can help, but they serve different needs and have different limits. Key differences Provider type Online therapy platforms: licensed psychologists, clinical social workers, LMFTs, psychiatrists or nurse practitioners. Mental‑health apps: in‑app programs, guided exercises, AI chatbots, or nonclinical coaches. Services offered Platforms: live video/phone sessions, structured therapy (CBT, DBT, psychodynamic), progress notes, sometimes medication management. Apps: mood tracking, guided meditations, breathing exercises, CBT-based modules, chatbots, sleep tools. Clinical scope Platforms: suitable for mild to severe mental‑health conditions that need assessment, diagnosis, ongoing therapy, or medication. Apps: best for self‑management, prevention, stress reduction, skills practice; not a substitute for clinical care if you have moderate/severe symptoms, suicidal thoughts, or complex psychiatric conditions. Regulation and evidence Platforms: providers are licensed and regulated; care is similar to in‑person therapy. Apps: evidence varies widely — some have clinical trials (e.g., certain CBT programs), many do not. Communication style & timing Platforms: scheduled video/phone sessions or live messaging with clinician; more in‑depth. Apps: on‑demand, asynchronous, brief interactions, or automated. Cost & payment Platforms: per session or subscription; some accept insurance or employee benefits. Apps: many freemium subscriptions, lower cost, or free core features. Who should pick which? Choose an online therapy platform if you need diagnosis, ongoing psychotherapy, medication evaluation, or have moderate to severe anxiety/depression, trauma, or relationship issues. Choose a mental‑health app for daily stress, sleep support, meditation, habit building, mood tracking, or as a supplement to therapy. Example services (and why) Online therapy platforms BetterHelp — large network of licensed therapists, flexible scheduling and messaging, subscription model. Good for general talk therapy and accessibility. Talkspace — offers texting and live video with licensed clinicians; also has psychiatry/medication options in some plans. SonderMind — focuses on matching you with local licensed clinicians and accepts some insurance; good if you want insurance coverage. Amwell / Teladoc Behavioral Health — telehealth platforms that include psychiatrists and therapists; often integrated with insurance and primary care. Mental‑health apps Headspace — evidence‑based meditation and sleep programs; user‑friendly for mindfulness and stress reduction. Calm — strong library of sleep stories, meditations, and breathing exercises; good for sleep and anxiety management. Woebot — CBT‑based chatbot that gives brief, guided conversations and skills practice; useful for on‑demand support and learning CBT techniques. Wysa — AI chatbot plus option to connect with human coaches/therapists; combines self‑help with human support if needed. Moodnotes / Daylio — mood‑tracking and journaling apps that help identify patterns and cognitive reframing. Safety notes If you’re in crisis or having suicidal thoughts, contact emergency services or a crisis line immediately (in the U.S. call 988). Apps and platforms are not substitutes for emergency care. Check privacy policies — some apps collect/share data for research or ads. Platforms that provide clinical care typically have HIPAA protections if they bill insurance. How to choose Check the provider’s credentials (licensed clinicians? psychiatrists for meds?). Look for trial periods, insurance or EAP coverage, and cancellation policies. Try combining both: a therapist plus a meditation or mood‑tracking app can be complementary. Read reviews and privacy terms; ask the platform about crisis procedures and licensing in your state/country. If you want, tell me your goal (therapy, medication, stress/sleep support, budget) and I can recommend the best specific option for you.

Mentioned in position 6 of 11

Online Therapy Platforms vs. Mental Health Apps Great question! These are quite different in what they offer: Online Therapy Platforms These connect you with licensed, real human therapists via video, phone, or messaging. Examples: BetterHelp – large network of therapists, good for general mental health Talkspace – strong for therapy plus psychiatry/medication management Cerebral – good if you need both therapy and prescriptions Brightside – specializes in depression and anxiety Best for: Diagnosed conditions, serious mental health concerns, ongoing treatment Mental Health Apps These are self-guided tools using exercises, tracking, or AI – no licensed therapist involved. Examples: Calm/Headspace – meditation and stress reduction Woebot – AI-based cognitive behavioral therapy exercises Daylio – mood tracking Sanvello – anxiety and depression coping tools Best for: Mild stress, building healthy habits, supplementing existing therapy Key Differences at a Glance Online Therapy Mental Health Apps Licensed therapist ✅ Yes ❌ No Cost Higher ($60-$100+/week) Low or free Clinical treatment ✅ Yes ❌ No Bottom line: If you're dealing with significant mental health challenges, choose a therapy platform. Apps work well as supportive tools alongside professional care.

Mentioned in position 6 of 9

Short answer: a lot can help. Lifestyle, behavioral therapies, some non‑hormonal prescriptions, pelvic‑floor care, targeted OTC products, and certain complementary approaches all reduce perimenopause symptoms. Which will work best depends on your main symptoms (hot flashes, sleep disturbance, mood, vaginal dryness, urinary problems, bone loss, etc.). Below is a practical, symptom‑focused guide with specific names you can discuss with your clinician. General/lifestyle (effective for many symptoms) Cooling and trigger avoidance for hot flashes: breathable cotton or moisture‑wicking layers, a portable fan, cool pillow/bed sheets (e.g., Chillum/Tempur‑type cooling pillows), avoid spicy foods, alcohol and evening caffeine. Exercise: regular aerobic activity + 2+ days/week of resistance training helps mood, sleep, weight and bone health. Apps/devices: Nike Training Club, Peloton app, or simple local gyms. Sleep hygiene and CBT‑I: consistent schedule, limit screens before bed, dark/cool bedroom. Online CBT‑I programs like Sleepio can be very effective. Stress reduction: mindfulness/meditation and gentle movement (yoga, tai chi). Apps: Headspace, Calm; or local classes. Stop smoking and limit alcohol—both worsen hot flashes and cardiovascular risk. For hot flashes / night sweats (non‑hormonal medicines and techniques) SSRIs/SNRIs: low‑dose paroxetine (Brisdelle—approved for hot flashes), venlafaxine (Effexor), escitalopram (Lexapro) can reduce frequency/intensity. Important: paroxetine and fluoxetine can interfere with tamoxifen — check with your clinician. Gabapentin (Neurontin): especially helpful for night sweats. Clonidine (Catapres): sometimes used, but watch for low blood pressure/dizziness. Behavioral options: paced respiration, CBT specifically for hot flashes, and clinical hypnosis have evidence for some people. Discuss side effects and interactions with your prescriber. For sleep problems CBT‑I (Sleepio or a trained therapist) is first‑line. Melatonin (low dose, short course) can help sleep onset; brands like Natrol or Life Extension are commonly used. Address hot flashes/night sweats (see above) if they disrupt sleep. For mood, anxiety, brain fog CBT and talk therapy, exercise, good sleep, and antidepressants (SSRIs/SNRIs) when indicated. Teletherapy services (BetterHelp, Talkspace) or local therapists who specialize in perimenopause/menopause can help. Omega‑3 supplements have modest evidence for mood support; discuss quality/brands with your clinician (Nordic Naturals is a reputable brand). For vaginal dryness and painful sex Non‑hormonal vaginal moisturizers and lubricants: Replens (moisturizer), Sliquid, Good Clean Love, K-Y HYDRATE or K-Y Jelly (for intercourse). These are safe and effective first steps. Vaginal laser therapies and other devices exist but have mixed evidence and cost/risks—ask a gynecologist before pursuing. For urinary symptoms / pelvic pain / sexual dysfunction Pelvic floor physical therapy (specialist PTs listed via American Physical Therapy Association directory or PelvicPain.org) is often very effective. Bladder training and pelvic floor exercises. Bone and heart health (prevention) Weight‑bearing exercise, calcium + vitamin D supplementation as needed, smoking cessation, healthy diet, and cardiovascular risk assessment. For supplements, brands like Citracal (calcium) and standard vitamin D supplements are widely used. See PCP for bone density (DXA) screening. Supplements and herbs (variable evidence) Soy isoflavones, black cohosh, red clover and evening primrose oil have mixed/limited evidence and can act like mild estrogens in some cases—talk to your clinician before starting, especially with breast‑cancer history. Vitamin E has small benefits for hot flashes in some studies. Quality brands: NOW Foods, Nature Made. Be cautious: supplements are not FDA‑regulated tightly and can interact with medicines. Complementary therapies Acupuncture reports mixed but sometimes helpful benefit for hot flashes and mood. Hypnosis and mindfulness have some supportive data for vasomotor symptoms. When to see a clinician If symptoms are severe or affecting daily life, see your gynecologist, primary care physician or a menopause clinic. They can tailor non‑hormonal meds safely (consider interactions like tamoxifen), evaluate other causes (thyroid, sleep apnea, depression), and discuss whether local estrogen or systemic hormones are worth revisiting. If you want, tell me which symptoms bother you most (hot flashes, sleep, mood, vaginal dryness, urinary issues, bone concerns, or other) and I’ll give a short, prioritized plan with specific options you can bring to your clinician.

Mentioned in position 6 of 19

It's fantastic that you're exploring non-hormonal options for perimenopause symptoms! Many women find significant relief without traditional hormone therapy. The key is often a combination of lifestyle adjustments, targeted supplements, and sometimes prescription medications that aren't hormones. Important Disclaimer: Always consult with your doctor or a qualified healthcare provider before starting any new treatments, supplements, or making significant lifestyle changes, especially during perimenopause. They can help you determine the best and safest approach for your individual needs. Here are several categories of non-hormonal approaches, with specific brand/service recommendations where applicable: Lifestyle Adjustments (Foundational) These are often the most impactful and should be the first line of defense. Dietary Changes: Focus: A whole-foods, plant-rich, anti-inflammatory diet can help stabilize blood sugar (reducing hot flashes, mood swings), support gut health, and manage weight. Think Mediterranean-style. Why it helps: Reduces inflammation, supports stable energy, provides essential nutrients. Recommendation: Consider working with a registered dietitian specializing in women's health. Search for "menopause nutritionist" or look into services like Thrive Market for easy access to healthy pantry staples, or HelloFresh / Blue Apron for meal kits that can help you integrate more whole foods. Avoid/Reduce: Caffeine, alcohol, spicy foods, and processed sugars, as these can trigger hot flashes and disrupt sleep. Regular Exercise: Focus: A mix of cardio, strength training, and flexibility. Why it helps: Improves mood, reduces stress, aids in weight management, strengthens bones (crucial for menopause), and can improve sleep. Recommendation: Peloton (or similar apps like Apple Fitness+): Offers a huge variety of classes (strength, cardio, yoga, meditation) you can do at home. Local Yoga or Pilates Studios: Excellent for flexibility, core strength, and stress reduction. Walking/Hiking: Free, accessible, and great for mental health. Stress Management: Focus: Chronic stress exacerbates many perimenopause symptoms. Why it helps: Lowers cortisol, improves mood, reduces anxiety, can lessen the intensity of hot flashes. Recommendation: Calm or Headspace apps: Guided meditation, sleep stories, and mindfulness exercises. Journaling: A simple notebook and pen can be a powerful tool. Deep Breathing Exercises: Even 5 minutes a day can make a difference. Sleep Hygiene: Focus: Establishing a consistent, calming bedtime routine. Why it helps: Crucial for energy, mood regulation, and overall well-being. Recommendation: Avoid screens an hour before bed. Keep your bedroom cool, dark, and quiet. Consider a Chillow Pillow or BedJet for hot flash relief at night. Oura Ring or Whoop Strap: Tracks sleep patterns and provides insights to help you optimize. Targeted Supplements (Discuss with your doctor first!) The efficacy of many supplements varies, and some can interact with medications. For Hot Flashes & Night Sweats: Black Cohosh: Some studies suggest it can reduce hot flashes for some women. Brands: Gaia Herbs Black Cohosh, Pure Encapsulations Black Cohosh. Soy Isoflavones/Red Clover: These are phytoestrogens (plant compounds that weakly mimic estrogen) and may offer mild relief for some. Brands: NOW Foods Soy Isoflavones, Nature's Way Red Clover. Pycnogenol (French Maritime Pine Bark Extract): Some research shows it can improve hot flashes and other symptoms. Brands: Healthy Origins Pycnogenol, Life Extension Pycnogenol. For Mood Swings, Anxiety, & Sleep: Magnesium: Many women are deficient. Can help with muscle relaxation, sleep, and anxiety. Why it helps: Supports neurotransmitter function, muscle relaxation. Brands: Thorne Magnesium Bisglycinate, NOW Foods Magnesium Citrate. Omega-3 Fatty Acids (Fish Oil): May help with mood regulation and overall inflammation. Why it helps: Brain health, anti-inflammatory. Brands: Nordic Naturals Ultimate Omega, Viva Naturals Omega-3 Fish Oil. L-Theanine: An amino acid found in green tea, can promote relaxation without drowsiness. Brands: Suntheanine L-Theanine (a patented form), NOW Foods L-Theanine. For Vaginal Dryness (Topical/Local): Non-Hormonal Vaginal Moisturizers: Applied regularly, these can improve tissue hydration. Why it helps: Directly addresses dryness and discomfort, especially for sex. Brands: Replens Long-Lasting Vaginal Moisturizer, Revaree (hyaluronic acid suppositories), Good Clean Love Biotics pH Balanced Vaginal Moisturizer. Lubricants (Water- or Silicone-Based): Used during intimacy. Brands: Slippery Stuff, Astroglide, LubeLife. Bone Health: Vitamin D3 & K2: Crucial for calcium absorption and bone density. Why it helps: Prevents bone loss. Brands: NatureMade Vitamin D3, Garden of Life Vitamin D3 & K2. Calcium: Often taken with D3. Best absorbed through diet. Brands: NOW Foods Calcium & Magnesium, Citracal. Prescription Non-Hormonal Medications Your doctor might consider these for more severe symptoms, especially hot flashes or mood disturbances, when lifestyle changes and supplements aren't enough. SSRIs/SNRIs (Antidepressants): Why it helps: Certain low-dose SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) can significantly reduce hot flashes and also help with mood swings, anxiety, and sleep disturbances. Examples: Brisdelle (a low-dose paroxetine specifically approved for hot flashes), Venlafaxine (Effexor), Escitalopram (Lexapro). Gabapentin (Neurontin): Why it helps: An anti-seizure medication that has been shown to be effective in reducing hot flashes and improving sleep for some women. Clonidine: Why it helps: A blood pressure medication that can also help reduce hot flashes for some individuals. Mind-Body Practices & Other Therapies Acupuncture: Why it helps: Some women report reduced hot flashes, improved sleep, and better mood after acupuncture sessions. Research is mixed but many find it beneficial. Recommendation: Find a licensed acupuncturist in your area. Cognitive Behavioral Therapy (CBT): Why it helps: A type of talk therapy that can help women manage bothersome symptoms like hot flashes, sleep disturbances, and anxiety by changing thought patterns and behaviors. Recommendation: Ask your doctor for a referral to a therapist specializing in CBT, or explore online platforms like BetterHelp or Talkspace. Specialized Support Telehealth Services for Menopause: Why it helps: These platforms connect you with providers specializing in perimenopause and menopause, offering personalized advice and prescription options. Brands: Gennev, MenoLabs, Evernow. Finding what works best often involves trial and error and a personalized approach. Be patient with yourself, keep a symptom journal to track what helps (and what doesn't), and maintain open communication with your healthcare provider. You've got this!

Mentioned in position 7 of 36

It sounds like you're in the thick of perimenopause or menopause, and those symptoms can be incredibly disruptive. The good news is there are many effective ways to manage hot flashes and improve sleep. Given your age and symptoms, it's really important to consult with your doctor or a gynecologist to discuss the best treatment plan for you, as they can assess your full health history and potential risks. Here's a breakdown of common treatment options: Hormone Therapy (HT or HRT) This is often considered the most effective treatment for hot flashes and night sweats, which can significantly improve sleep. What it is: Replaces the hormones (estrogen, sometimes progesterone) your body is no longer producing. Why it helps: Directly addresses the hormonal fluctuations causing hot flashes and often improves sleep, mood, and vaginal dryness. Types: Can be systemic (pills, patches, gels, sprays) or local (vaginal creams, rings, tablets for localized symptoms). Your doctor will discuss the pros and cons, especially regarding your medical history (e.g., risk of blood clots, certain cancers). Non-Hormonal Prescription Medications If hormone therapy isn't suitable or preferred, several prescription medications can help manage hot flashes and improve sleep. Antidepressants (SSRIs/SNRIs): Certain low-dose antidepressants can reduce hot flashes even in women who aren't depressed. Specific Brands: Brisdelle (paroxetine): This is the only non-hormonal medication specifically approved by the FDA for treating moderate to severe hot flashes. Effexor XR (venlafaxine): An SNRI that can be effective for hot flashes. Pristiq (desvenlafaxine): Another SNRI that can help with hot flashes. Why they help: They affect neurotransmitters in the brain that play a role in temperature regulation. Gabapentin: An anti-seizure medication that has been shown to reduce hot flashes and can also help with sleep. Specific Brand: Neurontin. Why it helps: It influences neurotransmitters involved in nerve activity and pain, and also has a sedative effect. Oxybutynin: A medication primarily used for overactive bladder, but it can also effectively reduce hot flashes. Specific Brand: Ditropan. Why it helps: It affects nerve signals that influence sweating and temperature regulation. Clonidine: A blood pressure medication that can sometimes be prescribed off-label for hot flashes, though it's generally less effective than other options. Specific Brand: Catapres. Why it helps: It affects blood vessels and nerve signals. Lifestyle Modifications & At-Home Strategies These are crucial for managing symptoms and improving overall well-being, especially sleep. Sleep Hygiene: Keep cool: Ensure your bedroom is cool. Consider cooling pillows or specialized mattress pads. Specific Brands/Services: ChiliSleep or Eight Sleep offer mattress pads with active cooling systems that can make a huge difference for night sweats. Regular schedule: Go to bed and wake up at the same time every day, even on weekends. Avoid triggers: Limit caffeine and alcohol, especially in the evening. Avoid heavy meals close to bedtime. Relaxation: Establish a relaxing bedtime routine (warm bath, reading, gentle stretching). Limit screens: Avoid phones, tablets, and computers an hour before bed. Stress Management: Stress can exacerbate both hot flashes and sleep problems. Practices: Yoga, meditation, deep breathing exercises. Specific Services: Apps like Calm or Headspace offer guided meditations and sleep stories. Diet & Exercise: Balanced diet: Focus on whole foods, fruits, vegetables. Some find avoiding spicy foods helps. Regular exercise: Can improve sleep and reduce stress, but avoid intense exercise too close to bedtime. Dress in layers: Wear breathable fabrics like cotton or moisture-wicking materials. Cognitive Behavioral Therapy for Insomnia (CBT-I): This is a highly effective, non-drug treatment for chronic insomnia. Why it helps: It teaches you to identify and change thoughts and behaviors that prevent you from sleeping well. Specific Services: You can find therapists specializing in CBT-I, or explore online programs like Sleepio (which can be covered by some insurance plans or employers). Complementary and Alternative Therapies (with caution) While many women explore these, scientific evidence for their effectiveness is often limited or mixed, and quality control can vary greatly. Always discuss these with your doctor, as they can interact with other medications. Phytoestrogens: Compounds found in plants that have estrogen-like effects. Sources: Soy products (tofu, tempeh), flaxseed. Why it helps: Some women find relief from mild hot flashes, but results vary. Herbal Supplements: Examples: Black cohosh, red clover, evening primrose oil. Caution: Efficacy is highly debated, and potential side effects or interactions are a concern. Always consult your doctor before taking any herbal supplements. Acupuncture: Some women report improvement in hot flashes and sleep with acupuncture. Remember, finding the right combination of treatments often involves some trial and error. Working closely with your healthcare provider will help you navigate your options safely and effectively to regain control over your symptoms and get better sleep.

Mentioned in position 10 of 11

Finding the "best" non-hormonal treatment can be very individual, as what works well for one person might not for another. It's always best to consult with your doctor to discuss your specific symptoms and medical history before starting any new treatment, especially prescription medications or supplements. Here are some of the most recommended non-hormonal treatments for hot flashes, along with specific brands or services where applicable: Prescription Non-Hormonal Medications (Discuss with your Doctor) These are generally the most effective non-hormonal options and are prescribed by a healthcare provider. SSRIs and SNRIs (Antidepressants): Even without depression, certain antidepressants have been found to significantly reduce hot flashes by affecting neurotransmitters involved in temperature regulation. Brisdelle (Paroxetine): This is the only FDA-approved non-hormonal prescription medication specifically for moderate to severe hot flashes. It's a low-dose form of paroxetine. Effexor XR (Venlafaxine): Often prescribed off-label and can be very effective for many women. Pristiq (Desvenlafaxine) or Lexapro (Escitalopram): Other SNRIs/SSRIs that may be considered. Why they help:* They influence serotonin and norepinephrine levels in the brain, which play a role in the body's thermoregulatory system. Gabapentin (Neurontin): Originally developed for seizures, it has been found to be effective in reducing hot flashes for some women, particularly those experiencing night sweats. Why it helps:* Its exact mechanism for hot flashes isn't fully understood, but it's thought to affect nerve activity. Clonidine: A blood pressure medication that can also help some women with hot flashes, though it's generally less preferred due to potential side effects like dry mouth or dizziness. Why it helps:* It acts on the central nervous system to reduce the severity and frequency of hot flashes. Oxybutynin: Primarily used for overactive bladder, this medication has also shown promise in reducing hot flashes and sweating in some studies. Why it helps:* It works by blocking certain receptors (anticholinergic effect) that can influence sweating and thermoregulation. Lifestyle and Behavioral Approaches (First Line of Defense) These are crucial for managing symptoms and have no side effects. Layered Clothing: Why it helps:* Allows you to quickly adjust your body temperature by removing or adding layers as a hot flash starts or subsides. Opt for natural, breathable fabrics like cotton, linen, or bamboo. Keeping Cool: Portable Fans: Keep one at your desk or bedside. Brands like Dyson offer high-quality, quiet fans, or simpler, affordable battery-operated fans are great for on-the-go. ChiliSleep or BedJet: These systems cool or warm your bed directly, which can be a game-changer for night sweats. Why it helps:* Directly reduces ambient temperature and provides immediate relief when a hot flash hits. Trigger Avoidance: Why it helps:* Identifying and avoiding your personal triggers can significantly reduce the frequency and intensity of hot flashes. Common triggers include: Spicy foods Caffeine Alcohol Hot beverages Smoking Stress Warm environments Stress Reduction Techniques: Mindfulness/Meditation Apps: Calm or Headspace offer guided meditations and breathing exercises. Yoga or Tai Chi: Look for local classes or online resources like Yoga with Adriene on YouTube. Why it helps:* Stress is a major hot flash trigger. Reducing stress can lower the frequency and intensity of flashes. Weight Management: Why it helps:* Studies show that women who are overweight or obese often experience more severe hot flashes. Losing even a small amount of weight can sometimes provide relief. Over-the-Counter & Complementary Therapies Evidence for these varies, and results can be inconsistent. Always discuss with your doctor before taking supplements due to potential interactions. Cooling Products: Mission Cooling Towels: These towels stay cool when wet and can be draped around your neck for immediate relief. Cooling Sprays or Gels: Various brands offer instant cooling sensations. Why they help:* Provide immediate, temporary localized cooling. Black Cohosh: Gaia Herbs Black Cohosh or Nature's Way Black Cohosh: These are reputable brands. Why it's used:* It's one of the most studied herbal remedies for menopausal symptoms. Some women find relief, but studies are mixed, and it's not effective for everyone. It should be used with caution, and ideally under medical supervision. Phytoestrogens (from diet): Soy Products: Tofu, tempeh, edamame, soy milk (e.g., Eden Organic, Silk). Flaxseed: Ground flaxseed can be added to smoothies, yogurt, or oatmeal (e.g., Bob's Red Mill). Why they're used:* Plant compounds that weakly mimic estrogen in the body. Some women in cultures with high phytoestrogen diets report fewer menopausal symptoms. Effects can vary widely. Acupuncture: Why it's used:* Some women report significant relief from hot flashes and other menopausal symptoms with regular acupuncture sessions. The mechanism isn't fully understood, but it's believed to help balance the body's energy and nervous system. Cognitive Behavioral Therapy (CBT): Why it helps:* While it doesn't stop the physiological event of a hot flash, CBT helps you change your reaction to them, reducing the distress and impact on your daily life, which can make them feel less severe and disruptive. Remember, the "best" approach often involves a combination of strategies. Start with lifestyle adjustments and discuss prescription options with your doctor if your symptoms are significantly affecting your quality of life.

Mentioned in position 5 of 11